EMMANUEL MENDOZA PA-C
NPI 1225856602
Physician Assistant in Vancleave, MS

Q: What is Emmanuel Mendoza's NPI number?

The NPI number for Emmanuel Mendoza is 1225856602. It was assigned to this individual provider in the NPPES registry on October 2, 2024. The provider is also known as Manny Mendoza.

Q: What is Emmanuel Mendoza's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Emmanuel Mendoza was last updated on February 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 02, 2024PECOS EnrolledAccepts Medicare Assignment

6300 E LAKE BLVD STE 201, VANCLEAVE, MS 39565(228) 230-2663 Get Directions Write a Review

NPPES record last updated: February 25, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 25, 2025, Oct 2, 2024 (2 updates tracked since 2024).

On this page

About Emmanuel Mendoza Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EMMANUEL MENDOZA PA-C (NPI 1225856602) is an individual physician assistant in Vancleave, Mississippi, licensed in Mississippi (PA00846) and active in the NPI registry since October 2024. He is enrolled in Medicare PECOS, is affiliated with Singing River Gulfport, and maintains a secondary practice location in Pascagoula.

NPPES Registry Identity

NPI1225856602

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameEMMANUEL MENDOZACredential: PA-C

Location Address6300 E LAKE BLVD STE 201Vancleave, MS 39565-6771

Mailing Address6300 E Lake Blvd Ste 301Vancleave, MS 39565-6771 · (228) 230-2663

Phone(228) 230-2663

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateOctober 2, 2024

Last NPPES UpdateFebruary 25, 20252 updates tracked since enumeration

NPPES CertifiedFebruary 25, 2025

✔ NPI 1225856602 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MS · PA00846

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

6300 E LAKE BLVD STE 201, Vancleave, MS 39565

Open in Google Maps ↗

Other Names 1

Other Name (5)Manny Mendoza

Secondary Practice Location 1

Location 13615 Hospital StPascagoula, MS 39581-4112 · Phone (228) 230-2663

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Emmanuel Mendoza Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5395269179

PECOS Enrollment IDI20250414002988

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Singing River Gulfport

Acute Care Hospitals · Gulfport, MS

1/5 CMS rating

OwnershipProprietary

CMS Certification Number250123

Location15200 Community RoadGulfport, MS 39503 · Harrison County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39565 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$64.96 typical visit price

range $16.15 – $129.61

Typical copayment $16.24 (range $4.03 – $32.40)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTINA M GARLOTTE FNP-C

Nurse Practitioner